Laparoscopic cholecystectomy without cholangiography: Is it a safe procedure?

Abstract

The charts of 304 cases of four-port laparoscopic cholecystectomy (LC) without cholangiography were studied retrospectively at King Fahad Hospital, Al Medinah Al Munawarah, Saudi Arabia, during a 2-year period. Electrocautery was used in all the cases. The majority of the patients (89.8%) had symptomatic chronic cholelithiasis and 68.4% of them had multiple stones. Thirty-three patients (10.86%) had 36 pre-operative endoscopic-retrograde-cholangiography (ERCP) procedures done on them. Fifteen patients (4.94%) had common bile duct (CBD) stones and the procedure was negative in the remaining patients. Two patients (0.66%) had CBD injury and three patients (O.99Y0) had bile leakage secondary to cystic duct injury. One patient (0.33%) had a retained CBD stone and he presented with biliary colic 1 month after his LC. The stone was removed endoscopically.There was no mortality. We believe that LC without cholangiography could be a safe procedure in a set-up equipped with appropriate endoscopic services.